Changes to pneumococcal vaccine schedule in U.K

The Department of Health and Social Care (DHSC) has announced its intentions to make changes to the pneumococcal vaccine schedule for infants in the UK. The changes were recommended by the Joint Committee for Vaccination and Immunisation (JCVI), an independent advisory committee to the DHSC. The changes, which are expected to be implemented in 2019 will reduce the number of pneumococcal vaccine doses offered to babies from three doses to two. The vaccine protects against diseases such as pneumonia, sepsis and bacterial meningitis.

The JCVI have released a statement in which they acknowledge the success of the pneumococcal vaccine in significantly reducing the incidence of pneumococcal diseases in the U.K.

A study published in the Lancet trialled the reduced vaccination schedule with 107 infants compared with 106 infants who received the original 3 doses. The study concluded that the immune responses for the infants on the reduced schedule were “equivalent or superior to those seen following the standard UK 2 + 1 schedule” for 9 of the 13 strains of pneumococcal bacteria that the vaccine prevents.

David Goldblatt, a vaccinology professor who led the study and is a member of the JCVI said that this study indicates that reducing the number of doses would not risk a large-scale disease outbreak. Goldblatt was quoted in the independent as saying: “There is a small but quantifiable chance a few more children might get an infection in the initial transition period but we think that number would be really small - maybe three or four children or 20 people across the whole population.”

CoMO urges the DHSC to consider all potential public health implications if moving forward with this proposal. The DHSC must be ready to respond to the potential increase in risk to public health and acknowledge that any increase of preventable disease is serious whether it is small or large in number.

Vinny Smith, Chief Executive of Meningitis Research Foundation, a UK, Irish and international charity, commented in their reaction to the news: “We would like clarity on when and how the dose of vaccine would be re-introduced if cases of this deadly disease increased."

Meningitis Now, a major UK Meningitis charity have released a statement expressing concern that the change may lead to an increase in pneumococcal meningitis. Meningitis Now are lobbying the Health Minister to communicate their message that “any increase in case numbers is unacceptable and that it will hold DHSC to account should case numbers escalate.”

Public trust in vaccines remains an issue critical to public health. Fortunately, the international outlook is encouraging, with MenACWY vaccines being introduced to the national immunisation programmes in Australia, the Netherlands and Spain in the last 12 months and Men B vaccines being adopted in the Spanish regions of Castile and Leon.

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